title: Benign prostatic hyperplasia: racial differences in treatment patterns and prostate cancer prevalence.
abstract: OBJECTIVE
  • To compare prostate cancer, prostate-related surgery and acute urinary retention rates, as well as associated healthcare resource use over 11 years in African American and Caucasian men with benign prostatic hyperplasia (BPH).
  
  
  METHODS
  • The BPH-related medical and surgical charges and events were determined for 398 African American men and 1656 Caucasian men followed for a mean of 10.2 years within a health maintenance organization. • Racial differences in clinical outcomes were evaluated using time-to-event analysis, stratifying results by baseline prostate-specific antigen (PSA) values.
  
  
  RESULTS
  • Risk of a prostate cancer diagnosis was 2.2 times greater in African American than Caucasian men (95% CI 1.48-3.35, P < 0.001) in analyses adjusting for serum PSA level. • Although African Americans were more likely to receive medical therapy for symptoms of BPH than Caucasians (43.5% vs 37.2%, respectively; P= 0.029), there were no clinically meaningful differences with respect to subsequent acute urinary retention or BPH-related surgery between them, or BPH-related medical charges (US $407 vs US $405 per month).
  
  
  CONCLUSIONS
  • As evidenced by this analysis of 'real-world' clinical practice, African Americans with BPH have a much greater risk of developing prostate cancer than similar Caucasian men highlighting the need for education and early detection in this population.
authors.affiliation: University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Pettaway
authors.forename: Lois E
authors.initials: LE
authors.lastname: Lamerato
authors.forename: Michael T
authors.initials: MT
authors.lastname: Eaddy
authors.forename: Jessie K
authors.initials: JK
authors.lastname: Edwards
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hogue
authors.forename: Martin M
authors.initials: MM
authors.lastname: Crane
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000453:epidemiology* / Q000208:ethnology* / Q000628:therapy; D011471:Prostatic Neoplasms / Q000208:ethnology*; D012307:Risk Factors; D016055:Urinary Retention / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D058891:5-alpha Reductase Inhibitors; D000317:Adrenergic alpha-Antagonists; D017430:Prostate-Specific Antigen